Direct acting antivirals (DAAs) have revolutionized treatment for hepatitis C. Combinations of DAAs can cure infection with HCV in 12 weeks, are highly effective and have limited side-effects. Affordability of DAAs has improved significantly, but access remains limited. Initially, due to their high prices, affordability of DAAs was limited in high-, middle- and low-income countries alike. Now there is a divide between those countries where, because of intellectual property barriers, prices have remained (very) high and other countries where generics are, or can be, available at much lower prices. The result is a dual market.